Branched‐chain amino acid‐enriched nutrients improve nutritional and metabolic abnormalities in the early post‐transplant period after living donor liver transplantation

Yoshida, Ryuichi; Yagi, T.; Shinmoto, Hiroshi; Matsuda, Hiroaki; Shinoura, Susumu; Umeda, Yuzo; Sato, Daisuke; Utsumi, Masashi; Nagasaka, Takeshi; Okazaki, N; Date, Ai; Noguchi, Ayako; Tanaka, Akemi; Hasegawa, Yūko; Sakamoto, Yachiyo; Fujiwara, Toshiyoshi

doi:10.1007/s00534-011-0459-5

Cited by 33 publications

(43 citation statements)

References 39 publications

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“…Their role in the management of the posttransplant period has not been evaluated carefully. There may be a beneficial role for perioperative branched-chain amino acid supplementation in improving immediate post liver transplant prealbumin and substrate utilization [48]. The role of amino acid supplementation in the long-term management of the posttransplant patient needs careful assessment.…”

Section: Discussionmentioning

confidence: 99%

Posttransplant Sarcopenia: An Underrecognized Early Consequence of Liver Transplantation

Dasarathy

2013

Dig Dis Sci

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Liver transplantation is believed to reverse the clinical and metabolic abnormalities of cirrhosis. Reduced skeletal muscle mass or sarcopenia contributes to increased mortality and adverse consequences of cirrhosis. Failure of reversal of sarcopenia of cirrhosis after liver transplantation is not well recognized. Six temporally, geographically, and methodologically distinct follow-up studies in 304 cirrhotics reported conflicting data on changes in indirect measures of skeletal muscle mass after transplantation. Distinct measures of body composition but not skeletal muscle mass were used and did not focus on the clinical consequences of sarcopenia after transplantation. A number of studies reported an initial rapid postoperative loss of lean mass followed by incomplete recovery with a maximum follow-up of 2 years. Posttransplant sarcopenia may be responsible for metabolic syndrome and impaired quality of life after liver transplantation. Potential reasons for failure to reverse sarcopenia after liver transplantation include use of immunosuppressive agents [mammalian target of rapamycin (mTOR) and calcineurin inhibitors] that impair skeletal muscle growth and protein accretion. Repeated hospitalizations, posttransplant infections, and renal failure also contribute to posttransplant sarcopenia. Finally, recovery from muscle deconditioning is limited by lack of systematic nutritional and physical-activity-based interventions to improve muscle mass. Despite the compelling data on sarcopenia before liver transplantation, the impact of posttransplant sarcopenia on clinical outcomes is not known. There is a compelling need for studies to examine the mechanisms and consequences of sarcopenia post liver transplantation to permit development of therapies to prevent and reverse this disorder.

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Section: Discussionmentioning

confidence: 99%

Posttransplant Sarcopenia: An Underrecognized Early Consequence of Liver Transplantation

Dasarathy

2013

Dig Dis Sci

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“…According to a previously report about perioperative nutritional assessment of living donor LTx, the liver glycogen storage capacities improved at an early period after LTx, and a much longer period was required to improve the hepatic protein synthetic capacity . In addition, the living donor LTx recipients were reported to fall into severe and prolonged post‐transplant catabolic state more frequently because of the necessity for regeneration of the split liver graft . On the other hands, the incidence of post‐transplant DM was reported to be lower in living donor LTx .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors of obesity, hypertension, dyslipidemia and diabetes mellitus before and after adult living donor liver transplantation

Hara

Kawagishi

Nakanishi

et al. 2014

Hepatology Research

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“…These roles range from cancer stem cell suppression to inhibition of reactive oxygen species (ROS). BCAA supplementation is also reported to improve insulin resistance and can promote liver regeneration (Miyake et al 2012; Nagao et al 2012; Tajiri and Shimizu 2013; Yoshida et al 2012). Determining the alterations in hepatic profiles of BCAA composition, with metabolism and signaling genes will provide important mechanistic information on the biochemical changes occurring in response to progression of this disease.…”

Section: Introductionmentioning

confidence: 99%

Branched chain amino acid metabolism profiles in progressive human nonalcoholic fatty liver disease

et al. 2014

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Nonalcoholic fatty liver disease (NAFLD) is a globally widespread disease of increasing clinical significance. The pathological progression of the disease from simple steatosis to nonalcoholic steatohepatitis (NASH) has been well defined, however, the contribution of altered branched chain amino acid metabolomic profiles to the progression of NAFLD is not known. The three BCAAs: leucine, isoleucine and valine are known to mediate activation of several important hepatic metabolic signaling pathways ranging from insulin signaling to glucose regulation. The purpose of this study is to profile changes in hepatic BCAA metabolite levels with transcriptomic changes in the progression of human NAFLD to discover novel mechanisms of disease progression. Metabolomic and transcriptomic data sets representing the spectrum of human NAFLD (normal, steatosis, NASH fatty, and NASH not fatty livers) were utilized for this study. During the transition from steatosis to NASH, increases in the levels of leucine (127 % of normal), isoleucine (139 %), and valine (147 %) were observed. Carnitine metabolites also exhibited significantly elevated profiles in NASH fatty and NASH not fatty samples and included propionyl, hexanoyl, lauryl, acetyl and butyryl carnitine. Amino acid and BCAA metabolism gene sets were significantly enriched among downregulated genes during NASH. These cumulative alterations in BCAA metabolite and amino acid metabolism gene profiles represent adaptive physiological responses to disease-induced hepatic stress in NASH patients.

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Branched‐chain amino acid‐enriched nutrients improve nutritional and metabolic abnormalities in the early post‐transplant period after living donor liver transplantation

Cited by 33 publications

References 39 publications

Posttransplant Sarcopenia: An Underrecognized Early Consequence of Liver Transplantation

Posttransplant Sarcopenia: An Underrecognized Early Consequence of Liver Transplantation

Prevalence and risk factors of obesity, hypertension, dyslipidemia and diabetes mellitus before and after adult living donor liver transplantation

Branched chain amino acid metabolism profiles in progressive human nonalcoholic fatty liver disease

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